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Sports ethics, sports medicine ethics, enhancement, and doping

Overview

Charles de Coubertin painting called Allégorie aux sports
Allégorie aux sports by Charles de Coubertin.

What types of enhancements are used in sport, and how should these be conceptualized and evaluated ethically? What policy responses are available for dealing with illegal enhancement use in sport, and what is the best policy?

Sports medicine straddles two areas whose aims are not always compatible. Sport, especially at the elite level, will emphasize success and resulting sponsorship, whereas for medicine the wellbeing of athletes will feature most highly. This disjunction can leave health care professionals involved in sport in an ethically complex space.

How should sports doctors and physiotherapists provide care in situations where the athlete's wellbeing is secondary (at best) to other aims? When employed by the team, a doctor or physiotherapist may have even more difficulty determining where their responsibilities and obligations lie. This can lead to many complicated questions:

  • Who to inform when a health issue arises in a team member?
  • How to respond to a coach who wants to return a player to the game before this is medically indicated?
  • What safeguards should sports health professionals put in place to keep themselves from becoming caught up in the imperatives of professional sport?

Codes of ethics are an integral mechanism for establishing standards in health care, and Lynley Anderson has been involved in developing these for practitioners in this area.

As well as investigating the relationship between health care and sport, individual issues also arise that stimulate interest and research. The causes and consequences of concussion in sport and its consequences is a growing field of knowledge, but given the limited understanding we have, what is the best way for sporting codes to respond? Likewise, our ability to accurately identify those at risk for sudden cardiac death in sport is also limited. Despite this, some wish to exclude those with identifiable risk factors even though to do so will mean banning many to reduce harm to few.

Risk is part of sporting endeavor, and can be both a positive and negative aspect of life. Given this, how ought we to evaluate and respond to risk when the purpose of many sports (eg base-jumping, mountain climbing, mixed martial arts) is to face extreme risk head on?

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Staff

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Collaborative research

  • Concussion in sport; and responding to uncertainty regarding the risks associated with collision sports.
  • Sporting management and the provision of health care
  • Sports Physiotherapy Ethics: Writing a code of ethics for sports physiotherapists
    • Dr Angela Cadogan, Physiotherapist
    • Michael Borich, Physiotherapist
    • Professor Tony Schneiders, Central Queensland University

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Publications

  • Anderson, L., & Jackson, S. (2013). Competing loyalties in sports medicine: Threats to medical professionalism in elite, commercial sport. International Review for the Sociology of Sport, 48(2), 238-256. doi: 10.1177/1012690211435031
  • Anderson, L., & Pickering, N.  (2013, September). Risky business. Verbal presentation at the Bioethics Centre 25th Anniversary Symposium: Sports Ethics, Dunedin, New Zealand
  • King, M. (2013, September). Dividing sport into enhanced and unenhanced leagues. Verbal presentation at the Bioethics Centre 25th Anniversary Symposium: Sports Ethics, Dunedin, New Zealand.
  • Anderson, L., Exeter, D., & Bowyer, L. (2012). Sudden cardiac death: Mandatory exclusion of athletes at risk is a step too far. British Journal of Sports Medicine, 46, 331-334. doi: 10.1136/bjsports-2011-090260
  • Anderson, L. C., & Bowyer, L. (2012). Sudden cardiac death screening and exclusion. Proceedings of the International Convention on Science, Education & Medicine in Sport (ICSEMIS): Sport … Inspiring a Learning Legacy. Retrieved from http://www.icsemis2012.com/
  • Anderson, L. (2012). A new code of ethics: Reflecting professional concerns [Guest editorial]. New Zealand Journal of Physiotherapy, 40(1), 1.
  • King, M. (2012, January). A league of their own? Evaluating justifications for the division of sport into "enhanced" and "unenhanced" leagues. Verbal presentation at the New Zealand Bioethics Conference: No Country for Old Men (or Women), Dunedin, New Zealand.
  • Anderson, L. (2012, September). Sudden cardiac death risk in athletes: Is there any place for mandatory exclusion of those at risk? Verbal presentation at the International Association for the Philosophy of Sport (IAPS) 40th Annual Conference, Porto, Portugal.
  • King, M. R. (2012). A league of their own? Evaluating justifications for the division of sport into 'enhanced' and 'unenhanced' leagues. Sport, Ethics & Philosophy, 6(1), 31-45. doi: 10.1080/17511321.2011.587198
  • Anderson, L. (2011, March). What becomes of the broken hearted: Cardiac screening and exclusion of athletes. Verbal presentation at the Future of Fairness Symposium, Dunedin, New Zealand.
  • Anderson, L. (2011). Bloodgate reversal of fortune [Blog commentary]. British Journal of Sports Medicine. Retrieved from http://bjsm.bmj.com/
  • King, M. (2011, March). A league of their own? Why dividing sport into "enhanced" and "unenhanced" leagues fails to solve the illegal enhancement problem in sport. Verbal presentation at the Future of Fairness Symposium, Dunedin, New Zealand
  • Anderson, L. (2010). Travelling light: Sports physiotherapists administering medications in the absence of a doctor. New Zealand Journal of Sports Medicine, 37(2), 38-42.
  • Anderson, L. (2010). Travelling light: Sports physiotherapists administering medications in the absence of a doctor. Proceedings of the New Zealand Sports Medicine+Science Conference, (pp. 52). Dunedin, New Zealand: Sports Medicine New Zealand.
  • Exeter, D., Osborne, H., McGarvey, J., & Anderson, L. (2010, November). Cardiac screening: Towards a consensus for New Zealand [Workshop]. Verbal presentation at the New Zealand Sports Medicine+Science Conference, Wellington, New Zealand.
  • Anderson, L. (2009). Are sports physiotherapists at risk of abandoning traditional obligations to their patients? New Zealand Journal of Physiotherapy, 37(3), (pp. 155).
  • Anderson, L. (2009). Writing a new code of ethics for sports physicians: Principles and challenges. British Journal of Sports Medicine, 43, 1079-1082. doi: 10.1136/bjsm.2008.051086
  • Paterson, R., & Anderson, L. (2009, November). Ethical issues in sports medicine. Guest speaker at the New Zealand Sports Medicine+Science Conference, Rotorua, New Zealand.
  • Anderson, L. (2008). Contractual obligations and the sharing of confidential health information in sport. Journal of Medical Ethics, 34(9), e6. doi: 10.1136/jme.2008.024794
  • Anderson, L. (2007). Doctoring risk: Responding to risk-taking in athletes. Sport, Ethics & Philosophy, 1(2), 119-134.
  • Anderson, L. (2006). Contractual vs traditional obligations: Confidentiality in sports medicine. Proceedings of the New Zealand Sports Medicine & Science Conference, (pp. 30). Dunedin, New Zealand: Sports Medicine NZ Inc.
  • Anderson, L. C., & Gerrard, D. F. (2005). Ethical issues concerning New Zealand sports doctors. Journal of Medical Ethics, 31(2), 88-92.

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